NCLEX RN Quiz Edition 1

NCLEX RN Quiz Edition 1

Helo, this is first post from https://nclex-question.blogspot.com, hope you enjoy with exercise. We have 5 question and answer also rationale

1. A mother of a toddler tells the nurse that she has a difficult time getting the child to go to bed at night.

The nurse suggests which of the following to the mother?

a. Inform the child of bedtime a few minutes before it is time for bed
b. Allow the child to have temper tantrums
c. Allow the child to set bedtime limits
d. Avoid a nap during the day

Answer:  A. Inform the child of bedtime a few minutes before it is time for bed
Rationale:  Most toddlers take an afternoon nap, and until approximately age 2 some also require a morning nap.  Toddlers often resist going to bed.  Firm consistent limits are needed for temper tantrums or when toddlers try stalling tactics.  Bedtime protests may be reduced by warning the child of bedtime a few minutes before the time.
Test-Taking Strategy:  Use the process of elimination.  Options 3 and 4 can be eliminated using the concepts of growth and development.  From the remaining options, select option 1 over option 2 because preparing the toddler for an event will minimize resistive behavior.  Review the concepts of growth and development as they relate to a toddler if you had difficulty with this question.

Level of Cognitive Ability:  Application
Client Needs:  Health Promotion and Maintenance
Integrated Process:  Nursing Process/Implementation
Content Area:  Child Health

References:

• Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, pp. 411-412. 
• Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, pp. 172-173.

2. A nurse provides information to the mother of a toddler regarding toilet-training.

The nurse avoids telling the mother which incorrect item?

a. Waiting until the child is 24 to 30 months old makes the task considerably easier
b. Bladder control is usually achieved before bowel control
c. The child should not be forced to sit on the potty for long periods
d. The ability of the child to remove clothing is a sign of physical readiness

Answer:  B. Bladder control is usually achieved before bowel control
Rationale:  Waiting until the child is 24 to 30 months old makes the task considerably easier, because toddlers of this age are less negative and usually more willing to control their sphincters to please their parents.  Bowel control is usually controlled before bladder control.  The child should not be forced to sit for long periods.  The ability to remove clothing is one of the physical signs of readiness.
Test-Taking Strategy:  Use the process of elimination.  Note the key words avoids and incorrect in the question.  These words indicate a false response question and that you need to select the incorrect item.  Option 3 can be eliminated first.  From the remaining options, recalling the physiological development of a toddler will assist in eliminating options 1 and 4 and direct you to the correct option.  Review the task of toilet training if you had difficulty with this question.
Level of Cognitive Ability:  Application
Client Needs:  Health Promotion and Maintenance
Integrated Process:  Teaching/Learning
Content Area:  Child Health

Reference:

• Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 177.

3. A mother of a 3-year-old child is concerned because the child is still insisting on a bottle at nap time and at bedtime.

The nurse suggests which of the following to the mother?

a. Do not allow the child to have the bottle
b. Allow the bottle during naps but not at bedtime
c. Allow the bottle if it contains juice
d. Allow the bottle if it contains water

Answer:  D. Allow the bottle if it contains water
Rationale:  A toddler should not be allowed to fall asleep with a bottle because of the risk of dental caries.  If the bottle is allowed in bed, it should contain only water.
Test-Taking Strategy:  Use the process of elimination.  Eliminate options 1 and 2 because they are similar.  From the remaining options, recalling that bottle dental caries is a risk in children will assist in directing you to option 4.  Review instructions regarding preventing dental caries if you had difficulty with this question.

Level of Cognitive Ability:  Application
Client Needs:  Health Promotion and Maintenance
Integrated Process:  Teaching/Learning
Content Area:  Child Health

Reference:

• Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 380.
• Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 175.

4. A nurse checks the vital signs of an infant with a respiratory infection and notes that the respiratory rate is 50 breaths per minute.

Which action is appropriate?

a. Notify the registered nurse
b. Administer oxygen
c. Recheck the respiratory rate in 15 minutes
d. Document the findings

Answer: 4. Document the findings
Rationale:  The normal respiratory rate in an infant is 30 to 60 breaths per minute.  The normal apical heart rate is 120 to 160 beats per minute, and the average blood pressure is 46 to 92/38 to 71 mm Hg.  The nurse would document the findings.
Test-Taking Strategy:  Knowledge regarding the normal vital signs of an infant is needed to answer this question.  If you had difficulty with this question, review these normal parameters.

Level of Cognitive Ability:  Application
Client Needs:  Physiological Integrity
Integrated Process:  Nursing Process/Implementation
Content Area:  Child Health

Reference:

• Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 48.

5. A nurse prepares to take a blood pressure (BP) measurement on a school-age child.

To obtain an accurate measurement, the nurse places the blood pressure cuff so that it covers:

a. One half of the distance between the antecubital fossa and the shoulder
b. One third of the distance between the antecubital fossa and the shoulder
c. Two thirds of the distance between the antecubital fossa and the shoulder
d. One fourth of the distance between the antecubital fossa and the shoulder

Answer: C. Two thirds of the distance between the antecubital fossa and the shoulder
Rationale:  The size of the BP cuff is important.  Cuffs that are too small will cause falsely elevated values, and those that are too large will cause inaccurate low values.  The cuff should cover two thirds of the distance between the antecubital fossa and the shoulder.
Test-Taking Strategy:  Use the process of elimination.  Visualize the placement measurements described in each of the options.  This will assist in directing you to option 3.  If you had difficulty with this question, review BP measurement in children.

Level of Cognitive Ability:  Application
Client Needs:  Physiological Integrity
Integrated Process:  Nursing Process/Implementation
Content Area:  Child Health

Reference:

• Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 30.

Source : NCLEX example quiz and answer

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